Organization
VALLEJO DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LONI VALLEJO DDS (OWNER)
(928) 277-0142
Entity
Organization
Contact information
Practice address
12075 E STATE ROUTE 69 STE 9, DEWEY, AZ 86327-4517
(928) 277-0142
(928) 277-0151
Mailing address
12075 E STATE ROUTE 69 STE 9, DEWEY, AZ 86327-4517
(928) 277-0142
(928) 277-0151
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7078
AZ
Other
Enumeration date
04/05/2016
Last updated
04/05/2016
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